5 Steps to Combat and Prevent Elder Abuse

What a new federal report recommends to curb this scourge

Not long ago, my aunt, who is in her 80s, was the victim of financial exploitation by an in-home health aide. It started with trips to the drugstore and small loans. Before long, the caregiver was regularly taking my aunt and her credit card to department stores to purchase clothes and other items — not for my aunt.

Eventually, a clerk noticed what was going on and alerted security and our family. By then, however, my aunt was out hundreds, possibly thousands of dollars. No charges were filed, but the caregiver was dismissed.

According to The Elder Justice Roadmap, a report just released by the U.S. Department of Justice and the Department of Health and Human Services, my aunt is one of 5 million Americans affected by some form of elder abuse each year (physical or mental abuse, neglect or financial exploitation). Most families, like ours, don't report such abuses to authorities; only one in 24 do, according to the study.

The Elder Justice Roadmap is intended to help people and organizations recognize, prevent and address the abuse and exploitation of older adults. One in every 10 people over 60 who lives at home suffers some form of abuse, neglect or exploitation, the report says. Those with dementia are far more likely to be abused or neglected by caregivers.

Contrary to popular belief, older adults are more likely to suffer abuse at the hands of their own family members than by a paid caregiver, according to Laura Mosqueda, a geriatrician and director of the National Center on Elder Abuse at University of California Irvine who served on the Elder Justice Roadmap steering committee.

Family caregiver abuse can stem from stress or financial motives. Mosqueda hopes the report will lead to more attention being paid to the factors that can lead to abuse and neglect at home.

"As a provider, I've seen families come in on the cusp of abuse and they are good people," she says. She hopes public awareness of elder abuse will rise to the level where families can get help before it's too late.

The 40-page report, based on interviews with more than 750 experts and professionals who work with older adults, recommends specific action in five areas:

1. Awareness The report calls for an increase in public awareness of elder abuse — a multi-faceted problem that requires a holistic, well-coordinated response in services, education, policy and research.

2. Brain health It also wants to see more research into brain health, with an enhanced focus on cognitive capacity (and incapacity) and mental health. These are critical factors both for elder abuse victims and for perpetrators.

3. Caregiving There should be better support and training for the tens of millions of paid and unpaid caregivers who play a critical role in preventing elder abuse, the Elder Justice Roadmap says.

4. Economics The authors want to see the costs of elder abuse quantified, particularly because this national problem includes huge fiscal costs to victims, families and society.

5. Resources The report says the nation needs to strategically invest more resources in services, education, research and expanding knowledge in order to reduce elder abuse in America.

Beyond its recommendations for the future, the report has already produced immediate benefits. The Department of Justice has created training modules to help attorneys recognize and address potential financial exploitation of older Americans. Also, the Department of Health and Human Services (HHS) is developing a voluntary national adult protective services data system to capture and analyze reports of abuse.

Mosqueda says healthcare providers and social workers need training to recognize the signs of abuse in their patients and clients. "So many age-related changes can mimic or mask signs of elder abuse — a fracture, bruise or pressure sore or burn — a lot of it is missed," she notes.

“Turning the tide against elder abuse requires much greater public commitment, so every American will recognize elder abuse when they see it and know what to do if they encounter it,” said Kathy Greenlee, HHS’ assistant secretary for aging and administrator of the Administration for Community Living, in a statement.

Toward that end, The National Center on Elder Abuse has developed an instructive Red Flags of Abuse Factsheet listing the signs of and risk factors for abuse and neglect.

The Administration on Aging says if you suspect that someone is in immediate danger of being an elder abuse victim, call 911 or contact your local adult protective services agency, which can be found through the National Center on Elder Abuse website or by calling 800-677-1116.

“We must take a stand to ensure that older Americans are safe from harm and neglect,” said Associate Attorney General Tony West in a statement. “For their contributions to our nation, to our society, and to our lives, we owe them nothing less.”